Roy's Adaptation Model

Sr. Callista Roy

 BACKGROUND
 Nurse theorist, writer, lecturer, researcher and teacher
 Professor and Nurse Theorist at the Boston College of Nursing in Chestnut Hill 
 Born at Los Angeles on October 14, 1939.
 Bachelor of Arts with a major in nursing - Mount St. Mary's College, Los Angeles in 1963. 
 Master's degree program in pediatric nursing - University of California ,Los Angeles in 1966. 
 Master’s and PhD in Sociology in 1973 and 1977.
 Worked with Dorothy E. Johnson 
 Worked as  faculty of Mount St. Mary's College in 1966.
 Organized course content according to a view of person and
family as adaptive systems. 
 RAM as a basis of curriculum at Mount St. Mary’s College
 1970-The model was implemented in Mount St. Mary’s
school
 1971- she was made chair of the nursing department at the
college.
 Major Concepts

 Adaptation -- goal of nursing

 Person -- adaptive system
 Environment -- stimuli
 Health -- outcome of adaptation
 Nursing- promoting adaptation and health
 Adaptation
 Responding positively to environmental changes.
 The process and outcome of individuals and groups
who use conscious awareness, self reflection and
choice to create human and environmental
integration.
 Person
 Bio-psycho-social being in constant interaction with a changing
environment 
 Uses innate and acquired mechanisms to adapt 
 An adaptive system described as a whole comprised of parts 
 Functions as a unity for some purpose 
 Includes people as individuals or in groups-families, organizations,
communities, and society as a whole.
 Environment
 Focal - internal or external and immediately confronting the person 
 Contextual- all stimuli present in the situation that contribute to effect of
focal stimulus 
 Residual-a factor whose effects in the current situation are unclear
 All conditions, circumstances, and influences surrounding and
affecting the development and behavior of persons and groups
with particular consideration of mutuality of person and earth
resources, including focal, contextual and residual stimuli
 HEALTH

 Inevitable dimension of person's life 

 Represented by a health-illness continuum 
 A state and a process of being and becoming
integrated and whole.
 Nursing
 To promote adaptation for individuals and groups in the
four adaptive modes, thus contributing to health, quality of
life, and dying with dignity by assessing behaviors and
factors that influence adaptive abilities and by intervening
to enhance environmental interactions.
 Four Adaptive Modes
 Physiologic Needs 
The way a person responds as a physical
being to stimuli from the environment.
Behavior in this mode is a manifestation of the
physiological activity of all the cells, tissues, organs, &
systems of the body.
 5 needs serve to promote physiological
integrity
 oxygenation
 nutrition
 elimination
 activity and rest
 and protection
4 processes which help maintain physiological
integrity
 senses
 fluid and electrolytes
 neuro
 and endocrine function
 SELF-CONCEPT

 Psychological and spiritual characteristics of the person consist of all

beliefs and feelings that one has formed about oneself.
 deals with the person’s beliefs & feelings about himself/herself.

 Two components:
a. Physical self
   b. Personal self
 PSYCHIC INTEGRITY
 physical perceptions
 ideals
 goals
 moral/ethical beliefs
 (1) self-consistency: one’s self-description of
qualities; also includes self-organization behavior
 (2) self-ideal/self-expectancy: what one would like to
do or be
 (3) moral-ethical-spiritual self: values, beliefs,
religion
 self-esteem: the value one places on himself/herself
 Physical self:
 how one sees his own physical being
 body sensation: ability to express sensations/feel symptoms
 body image: how one sees himself as a physical being
 how one views his qualities, values, worth
 Role Function
 A role is a set of expectations about a person occupying one’s
position behaves towards a person occupying another position.
 involves the position one occupies in society; behaviors associated
with one’s position (role) in society.
 Basic underlying need: social integrity
 Primary, secondary, or tertiary roles that a person performs in the
society. 
 Primary role: role based on age, sex, developmental
state
 Secondary role: role(s) a person assumes to complete
tasks associated with a primary role or developmental
stage
 Tertiary role: a role freely chosen; temporary;
associated with accomplishments of tasks or goals
 Interdependence
 associated with one’s relationships and interactions with
others and the giving and receiving of love, respect, and
value.
 Basic underlying need: nurturance and affection
 Significant others: intimate relationships (spouse, parent,
God)
 Support systems: less intimate relationships (coworkers,
friends)
 Giving behaviors: giving love, nurturance, affection
 Receiving behaviors: receiving/taking in love, nurturance,
affection
 Roy Model and the Nursing Process:
Utilizes a bi-level assessment to problem
solve
 Assessment of behaviors:

 Behavior is an action or reaction under specified circumstances;

behavior may be observable, or not.
 Normally, a person adapts to stimuli positively, maintaining a
“steady state” but in times of stress when coping mechanisms are
overwhelmed (i.e., illness), the person’s ability to adapt to a new
situation is impaired.
 The nurse observes behaviors (signs/symptoms) or responses of the
patient and makes a judgment as to whether the behavior is
adaptive or ineffective.
 How does the nurse do this? Assessment phase of nursing process
 Assessment of stimuli:

 Stimuli are the underlying causes or factors contributing

to the behaviors observed in first level assessment; those
things which provoke a response.
 Nurse identifies stimuli in all 4 adaptive modes; stimuli
are manipulated via interventions to achieve patient
goals
 Coping mechanism from close relationship which
results to giving and receiving of love, respect and
value.
 Occurs between the person and the most significant
other or between the person and support system.
 THANK YOU